RESUMEN
Urine output is an important clinical measurement and oliguria may highlight the development of acute kidney injury (AKI) earlier than serum creatinine (sCr). Despite the importance of urine output monitoring, there are no definitive guidelines or recommendations for best practice. A survey was sent to healthcare professionals with a specialist interest in AKI to gather opinions of what constitutes a good standard of urine output monitoring and by corollary missed care, post- major surgery. Data was gathered from 221 respondents. Results will inform audit and improvement projects in post-operative nursing care.
RESUMEN
Background: Outside critical care environments, few studies have assessed the significance of oliguric acute kidney injury (AKI). This study investigated the feasibility of an electronic fluid balance chart to diagnose oliguric AKI. Data were used to determine if oliguric AKI was met earlier than creatinine AKI and to establish outcomes of those who developed AKI. Methods: A single-centre prospective cohort study investigated Kidney Disease Improving Global Outcomes oliguric and creatinine AKI criteria on general surgical wards. Results: 2,149 cases were included in the analysis. Incidence of oliguric AKI was significantly higher than creatinine criteria (73 versus 10.1%) and detection occurred earlier (2.1 versus 6.1 days, p<0.05). In cases with oliguric AKI, 8.1% also developed AKI by creatinine criteria. In cases not meeting oliguric AKI criteria, fewer cases developed creatinine AKI, as compared to those meeting oliguric AKI criteria (7.9% versus 11%, p=0.043). There was a high incidence of missing data. Conclusions: Oliguric AKI was met in a high proportion of cases and occurred earlier than by changes in creatinine. Barriers to consistency of recording must be addressed before oliguric criteria could be implemented in clinical practice.